Healthcare Provider Details
I. General information
NPI: 1720555386
Provider Name (Legal Business Name): ANNABEL POLLY SLOVEK NP
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 10/31/2018
Last Update Date: 07/23/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
9305 W THOMAS RD STE 500
PHOENIX AZ
85037-3354
US
IV. Provider business mailing address
645 E MISSOURI AVE STE 300
PHOENIX AZ
85012-1351
US
V. Phone/Fax
- Phone: 602-242-5040
- Fax:
- Phone: 602-262-8900
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 163W00000X |
| Taxonomy | Registered Nurse |
| License Number | RN178307 |
| License Number State | AZ |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 363L00000X |
| Taxonomy | Nurse Practitioner |
| License Number | 220519 |
| License Number State | AZ |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: